Analysis of Factors Related to the Prognosis of Patients with Massive Transfusion

Abstract

Background : The prognostic indicators of patients who received massive transfusion were studied

to assist management of high risk patients.

Methods : Medical records and laboratory data of 184 adult patients who received massive

transfusions during 1996-1998 were reviewed. The indicators studied were outcome of treatment,

cause of transfusion, age, sex, vital sign at admission, number of units of blood components, results

of platelet counts (PIt), hematocrit (Hct), prothrombin time (PT), activated thromboplastin time

(aPTT) and arterial blood pH (pH) performed within 24 hours after transfusion.

Results : The percent and mean age of survivor were 60.3% and 44.8 years old and nonsurvivor

were 39.7 and 49.7, respectively. The frequency and survival rate by causative disorders were as

follows: trauma 33.2% and 56%; liver disease 23.9% and 57%, cancer 13.6% and 56%, cardiovascular

disorders 7.5% and 78.6%. Nonsurvivors had lower systolic and diastolic pressures in liver disease

and cancer, and lower body temperature in trauma patients than those of survivors. In trauma

patients nonsurvivors had lower PIt counts and pH, and prolonged PT and aPTT results than those

of survivors. In cancer patients nonsurvivors showed lower Hct and pH, but those of liver disease

patients showed only lower PIt counts. The average unit of blood components transfused per patient

in nonsurvivors were 27.3 of RBC, 13.4 of FFP, and 15.2 of platelet concentrate, respectively. The

percent of patients who were transfused more than 20 units of RBC was 28% in survivors, but 55%

in nonsurvivors.

Conclusions : It is concluded that the patients transfused with more than 20 units of RBC showed

low systolic and diastolic pressures, body temperature, PIt counts, Hct and arterial blood pH, and

prolonged PT and aPTT results appeared to be poor prognostic indicator of massive transfusions.